title: Adding days spent in readmission to the initial postoperative length of stay limits the perceived benefit of laparoscopic distal pancreatectomy when compared with open distal pancreatectomy.
abstract: BACKGROUND
  Published comparisons of laparoscopic (laparoscopic distal pancreatectomy [LDP]) to open distal pancreatectomy (ODP) identify improved lengths of stay (LOS) after LDP but do not include data on readmissions.
  
  
  METHODS
  Demographic, operative, and postoperative outcomes data for patients undergoing LDP or ODP between August 2007 and December 2009 were culled from our prospectively accruing pancreatic database. Electronic medical records were reviewed to determine cause, treatment, and LOS for readmissions.
  
  
  RESULTS
  Patients undergoing LDP were statistically identical to those undergoing ODP in regard to age, presentation, demographic characteristics, comorbidities, operative times, tumor sizes, morbidity, mortality, and pancreatic fistula rates. The initial LOS was statistically shorter for those undergoing LDP (4.8 ± .1 days vs 8.7 ± .1 days, P < .001). The readmission rate for LDP was statistically higher than for ODP (25% vs 8%, P < .05). Overall LOS for LDP was 7.2 ± .3 days versus 9.3 ± .1 days for ODP (P = .2).
  
  
  CONCLUSIONS
  Adding readmission LOS to initial LOS eliminates the perceived effect of LDP to accelerate recovery.
authors.affiliation: Department of Surgery, University of Chicago, Evanston, IL 60201, USA. mbaker3@northshore.org
authors.forename: Marshall S
authors.initials: MS
authors.lastname: Baker
authors.forename: David J
authors.initials: DJ
authors.lastname: Bentrem
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ujiki
authors.forename: Susan
authors.initials: S
authors.lastname: Stocker
authors.forename: Mark S
authors.initials: MS
authors.lastname: Talamonti
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology; D007415:Intestinal Obstruction / Q000209:etiology; D007511:Ischemia / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010182:Pancreatic Diseases / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery; D010195:Pancreatitis / Q000601:surgery; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013154:Spleen / Q000098:blood supply; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome